A majority of members of the Congressional Progressive Caucus will not support any health reform legislation that does not include a public plan option, according to a letter sent on Thursday by CPC co-chairs Reps. Lynn Woosley (D-Calif.) and Raúl Grijalva (D-Ariz.) to Democratic leaders in the House and Senate, Roll Call reports (Bendery, Roll Call, 4/2). According to The Hill, "The caucus is seeking to leverage its 77 votes, which is enough to block legislation on the House floor if Republicans are united against it."

Woosley and Grijalva in the letter said that a majority of CPC members "will only support comprehensive health care reform legislation that includes a public plan option on a level playing field with private health insurance plans." According to the letter, most caucus members prefer a single-payer health care system, but a public plan option should be included "at minimum."

House Majority Leader Steny Hoyer (D-Md.) said that House Democrats are committed to including a public plan option in health reform legislation. Hoyer added that although Senate Finance Committee Chair Max Baucus (D-Mont.) has expressed support for a public plan, he is working on developing bipartisan legislation with committee ranking minority member Chuck Grassley (R-Iowa), who opposes such an option (Soraghan, The Hill, 4/2).

Sen. Charles Schumer (D-N.Y.) on Thursday said that a possible compromise would be to create a plan similar to coverage that most states offer their employees, which would avoid expanding federal programs like Medicare and could be run by private insurers. State employee health insurance plans operate similarly to large companies' benefit plans in that they require an annual budget for health expenses and hire an insurer to process claims, negotiate rates and convince employees to adopt healthier lifestyles. The idea of using state employee plans as a model was introduced last month by health policy experts Len Nichols and John Bertko.

Mark McClellan, former CMS director under former President George W. Bush, called the proposal "well meaning" but said a federally backed plan would have a much greater impact on the insurance market because the government is significantly larger than any state. McClellan added, "At this point, I don't know many Republicans who are confident a public option could work without making it look like another private sector choice. And then, what would be the point?" (Alonso-Zaldivar, AP/Miami Herald, 4/2).

Subcommittee Hearing Focuses on Quality, Cost Effectiveness
In related news, members of the House Energy and Commerce Health Subcommittee on Thursday examined ways to increase quality and reduce costs in the U.S. health care system, CQ HealthBeat reports. One idea endorsed by several lawmakers at the hearing was to increase transparency in the pricing of services. Subcommittee Chair Frank Pallone (D-N.J.) said that while consumers have a right to greater transparency, it is not the panacea to controlling costs. Jonathan Skinner, a professor of economics at the Dartmouth Institute for Health Policy and Clinical Practice, said that regional disparities in Medicare spending need to be addressed as a way to control costs. He noted that recent studies have found higher spending is not necessarily linked to higher quality of care. Jerry Avorn, a professor of medicine at Harvard Medical School, suggested providing physicians with better information on the effectiveness of different drugs and treatment options, allowing them to make more informed decisions based on scientific analysis (Norman, CQ HealthBeat, 4/2).

Hoyer Urges Lawmakers To Discuss Health Reform Over Recess
In a memo sent to Democrats on Thursday, Hoyer urged lawmakers "to use the upcoming April District Work Period to launch a national discussion on the need for comprehensive health care reform," The Hill reports. Hoyer wrote that throughout the spring and summer, "[m]embers are encouraged to hold health care town hall meetings in their districts and plan other events to highlight the need for reform."

According to the memo, Hoyer's office is providing Democratic members with a binder of "resources to help you begin or continue health care reform outreach in your district, including town hall guides, event ideas, messaging materials, state-specific information, fact sheet handouts, and background materials that can all be tailored to your district." The Hill reports that the Obama administration has been planning events over the next several months and is using its vast network from the presidential campaign to build grassroots support for health care reform (Young, The Hill, 4/2).

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